Individual provider Active NPI

Adam Jensen, D.D.S.

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1396057030
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1511 Issued in AK
Practice address
240 E Tudor Rd Ste 110
Anchorage, AK 99503-7244
Phone
(907) 868-3000
Fax
(907) 802-2935
NPI assigned
Jul 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2407 MT
General Practice Dentistry 1223G0001X 1511 AK Primary

Addresses

Primary practice location

240 E Tudor Rd Ste 110
Anchorage, AK 99503-7244

Mailing address

240 E Tudor Rd Ste 110
Anchorage, AK 99503-7244
Phone (907) 868-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613001503 AK Order and Referring Only - DentistPractitioner - Dentist 9638469117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1511AKMDDentist
2407MTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chugach Dental, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10250/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1396057030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E TUDOR RD STE 110",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037244",
            "telephone_number": "907-868-3000",
            "fax_number": "907-802-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E TUDOR RD STE 110",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037244",
            "telephone_number": "907-868-3000",
            "fax_number": "907-802-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ADAM",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2407",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.